Depression is one of the most widespread psychological illnesses. It’s also one of the most devastating. To illustrate how bad depression can be I’m going to use a cautionary note that we psychologists get taught while we’re training.
The most dangerous time for someone with major depressive disorder (MDD) is not when they are at their lowest point. It can actually be when they start to recover that they are most at risk of suicide.
Because while people with MDD might wish to end their own lives when the depression is at its worst they are often unable to do so. The effects of the disorder are so strong that it can make people physically and mentally incapable of figuring out a way to end it all, and following through on the plan. But as they begin to recover they might be able to find just enough energy to reach for that bottle of pills…
Depression is a killer.
It’s also partly the result of an imbalance of neurotransmitters in the brain. In a way this means that it is similar to other illnesses like epilepsy. And this is a useful comparison.
Telling someone with depression to “just get over it” is like telling someone with epilepsy to “just walk it off”.
But while these explanations and comparisons can give us an idea of how serious depression can be they don’t tell us what it is. So here we go.
The three key facets of depression
Depression is three things:
- Physical symptoms
- Negative thought patterns
- Unhealthy behaviours
Naturally, all three of these things are endlessly intertwined with one another. Eating healthily mostly affects us on the physical level, but knowing that we’ve been eating healthily can give us a boost on an emotional level. Still, it’s often helpful to think of the three as being separate, sort of.
The physical aspects can be handled by eating right, exercising, getting enough sleep, and generally doing all of the things we know we should be doing, but often don’t.
It also often requires antidepressant medication, and there is nothing wrong with that. Remember the comparison to epilepsy; we don’t think less of people with epilepsy for taking medication. We shouldn’t think less of people with depression, either.
But medications only handle the physical symptoms, and one of the ways in which treatment for depression often fails is because the other two aspects get neglected. A study performed by the NHS found that antidepressant medication was almost ineffective as a treatment, unless the patients also had some form of emotional support. Because it’s with emotional support that we can find the energy and guidance to start thinking, and behaving, more healthily.
Medication can handle the bulk of the physical symptoms. The other two parts of depression you have to handle yourself.
Handle things yourself, with others
But you don’t have to handle them alone. Get therapy. Talk to your loved ones. Join a support group. Find a website for people like yourself. Practice mindfulness to help with depressive thoughts and get your friends to join you in meditation. Sit down with people you trust, talk about how you want to live better, and ask them what they think.
Understanding that depression has three different parts, and all of them need to be tackled, is just the first step.
But everything starts with a first step, including getting better.